Provider Demographics
NPI:1902661275
Name:LEWIS, VICTORIA BELLE MCCLAIN (MMFT, LMFT-A)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:BELLE MCCLAIN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MMFT, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 E MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2119
Mailing Address - Country:US
Mailing Address - Phone:864-383-9002
Mailing Address - Fax:
Practice Address - Street 1:945 E MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2119
Practice Address - Country:US
Practice Address - Phone:864-383-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8868106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist